Provider Demographics
NPI:1366628083
Name:DR. PATRICIA WU, DMD, PC
Entity Type:Organization
Organization Name:DR. PATRICIA WU, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEI-HUA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-322-0131
Mailing Address - Street 1:389 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5017
Mailing Address - Country:US
Mailing Address - Phone:781-322-0131
Mailing Address - Fax:781-322-6066
Practice Address - Street 1:389 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5017
Practice Address - Country:US
Practice Address - Phone:781-322-0131
Practice Address - Fax:781-322-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty